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Evaluating personality pathological profiles in temporal lobe epilepsy and functional seizures according to DSM-5 alternative model for personality disorders.

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Title: Evaluating personality pathological profiles in temporal lobe epilepsy and functional seizures according to DSM-5 alternative model for personality disorders.
Authors: Sammarra I; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: ilaria.sammarra@unicz.it., Martino I; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: martino.iole@gmail.com., Vono A; Department of Health Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: alessia.vono@gmail.com., Longo A; Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: anna.longo@studenti.unicz.it., Iusi IC; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: idacataldina.iusi@studenti.unicz.it., Fortunato F; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: francescofortunato@unicz.it., Gambardella A; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Græcia University of Catanzaro, Italy. Electronic address: a.gambardella@unicz.it.
Source: Epilepsy & behavior : E&B [Epilepsy Behav] 2026 Sep; Vol. 182, pp. 111110. Date of Electronic Publication: 2026 May 20.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Academic Press Country of Publication: United States NLM ID: 100892858 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-5069 (Electronic) Linking ISSN: 15255050 NLM ISO Abbreviation: Epilepsy Behav Subsets: MEDLINE
Imprint Name(s): Original Publication: San Diego, CA : Academic Press, c2000-
MeSH Terms: Epilepsy, Temporal Lobe*/complications , Epilepsy, Temporal Lobe*/psychology , Personality Disorders*/diagnosis , Personality Disorders*/etiology , Seizures*/complications , Seizures*/psychology , Diagnostic and Statistical Manual of Mental Disorders*, Humans ; Female ; Adult ; Male ; Middle Aged ; Psychiatric Status Rating Scales ; Personality Inventory ; Young Adult
Abstract: The 5th version of DSM introduced an Alternative Model for Personality Disorders (AMPD), which conceptualizes personality pathology as result of impairments in personality functioning and maladaptive personality traits. As well-known, personality disorders represent a common psychiatric comorbidity in Temporal Lobe Epilepsy (TLE) and Functional Seizures (FS). This study aims to characterize personality pathology in these populations according to DSM-5 AMPD using the Level of Personality Functioning Scale-Brief Form 2.0 and Personality Inventory for DSM-5. Furthermore, association between pathological personality traits and psychopathological or clinical variables was also explored. Ninety individuals with TLE and 61 with FS, along with 66 healthy controls prospectively underwent an extensive personality assessment as well as a psychopathological and behavioral evaluation. A pathological personality profile was identified more frequently in TLE (30/90,33.3 %) and FS (18/61,29.5 %) rather than in HC (10/66,15.2 %), with increased odds in both groups (TLE = 2.71;FS = 2.53). In detail, personality trait-specified profiles were the most common in TLE (37.5 %), whereas borderline personality profiles predominated in FS (43.5 %). Across both TLE and FS populations, individuals with concomitant pathological personality profiles showed higher levels of depression (TLE:p < 0.001;FS:p < 0.001), anxiety (TLE:p < 0.001;FS:p = 0.02), alexithymia (TLE:p < 0.001;FS:p = 0.002), dissociative symptoms (TLE:p < 0.001;FS:p = 0.03), impulsivity (TLE:p = 0.002;FS:p = 0.03), and emotional dysregulation (TLE:p < 0.001;FS:p = 0.003). A non-significant trend toward a higher prevalence of pathological personality profiles was observed in TLE individuals with recurrent seizures (OR = 2.29;p = 0.07). In conclusion, dimensional personality assessment revealed a great prevalence of pathological personality profile in TLE and FS, highlighting distinct distributions and strong association with broader psychopathological burden, supporting its clinical value in routine evaluation of these populations.
(Copyright © 2026. Published by Elsevier Inc.)
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Contributed Indexing: Keywords: Functional seizures; Personality profiles; Temporal lobe epilepsy
Entry Date(s): Date Created: 20260520 Date Completed: 20260610 Latest Revision: 20260610
Update Code: 20260610
DOI: 10.1016/j.yebeh.2026.111110
PMID: 42161157
Database: MEDLINE
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  Data: Evaluating personality pathological profiles in temporal lobe epilepsy and functional seizures according to DSM-5 alternative model for personality disorders.
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  Data: &lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Sammarra+I%22&quot;&gt;Sammarra I&lt;/searchLink&gt;; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: ilaria.sammarra@unicz.it.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Martino+I%22&quot;&gt;Martino I&lt;/searchLink&gt;; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: martino.iole@gmail.com.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Vono+A%22&quot;&gt;Vono A&lt;/searchLink&gt;; Department of Health Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: alessia.vono@gmail.com.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Longo+A%22&quot;&gt;Longo A&lt;/searchLink&gt;; Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: anna.longo@studenti.unicz.it.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Iusi+IC%22&quot;&gt;Iusi IC&lt;/searchLink&gt;; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: idacataldina.iusi@studenti.unicz.it.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Fortunato+F%22&quot;&gt;Fortunato F&lt;/searchLink&gt;; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: francescofortunato@unicz.it.&lt;br /&gt;&lt;searchLink fieldCode=&quot;AU&quot; term=&quot;%22Gambardella+A%22&quot;&gt;Gambardella A&lt;/searchLink&gt;; Institute of Neurology, Department of Medical and Surgical Sciences, Magna Gr&#230;cia University of Catanzaro, Italy. Electronic address: a.gambardella@unicz.it.
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  Data: The 5th version of DSM introduced an Alternative Model for Personality Disorders (AMPD), which conceptualizes personality pathology as result of impairments in personality functioning and maladaptive personality traits. As well-known, personality disorders represent a common psychiatric comorbidity in Temporal Lobe Epilepsy (TLE) and Functional Seizures (FS). This study aims to characterize personality pathology in these populations according to DSM-5 AMPD using the Level of Personality Functioning Scale-Brief Form 2.0 and Personality Inventory for DSM-5. Furthermore, association between pathological personality traits and psychopathological or clinical variables was also explored. Ninety individuals with TLE and 61 with FS, along with 66 healthy controls prospectively underwent an extensive personality assessment as well as a psychopathological and behavioral evaluation. A pathological personality profile was identified more frequently in TLE (30/90,33.3&#160;%) and FS (18/61,29.5&#160;%) rather than in HC (10/66,15.2&#160;%), with increased odds in both groups (TLE&#160;=&#160;2.71;FS&#160;=&#160;2.53). In detail, personality trait-specified profiles were the most common in TLE (37.5&#160;%), whereas borderline personality profiles predominated in FS (43.5&#160;%). Across both TLE and FS populations, individuals with concomitant pathological personality profiles showed higher levels of depression (TLE:p&#160;&amp;lt;&#160;0.001;FS:p&#160;&amp;lt;&#160;0.001), anxiety (TLE:p&#160;&amp;lt;&#160;0.001;FS:p&#160;=&#160;0.02), alexithymia (TLE:p&#160;&amp;lt;&#160;0.001;FS:p&#160;=&#160;0.002), dissociative symptoms (TLE:p&#160;&amp;lt;&#160;0.001;FS:p&#160;=&#160;0.03), impulsivity (TLE:p&#160;=&#160;0.002;FS:p&#160;=&#160;0.03), and emotional dysregulation (TLE:p&#160;&amp;lt;&#160;0.001;FS:p&#160;=&#160;0.003). A non-significant trend toward a higher prevalence of pathological personality profiles was observed in TLE individuals with recurrent seizures (OR&#160;=&#160;2.29;p&#160;=&#160;0.07). In conclusion, dimensional personality assessment revealed a great prevalence of pathological personality profile in TLE and FS, highlighting distinct distributions and strong association with broader psychopathological burden, supporting its clinical value in routine evaluation of these populations.&lt;br /&gt; (Copyright &#169; 2026. Published by Elsevier Inc.)
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  Data: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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